Apoptosis is the autonomous death of cells,which is controlled by the genes and to maintain the homeostasis of the body.Apoptosis is the important mechanism in the cell's growth and development.Recent studies have found that apoptosis can affect the neighboring cells physiological process in microenvironment through directly contact or release a series of regulatory factor,which plays an important roles in the construction of tumor microenvironment.Therefore,understanding the roles of apoptosis in the normal and tumor microenvironment has great significance for further study the pathogenesis,prevention and treatment of tumor.

BACKGROUND:The phenomenon of temporary ischemia of the tissues and organs caused by injury is common in the clinic. However, there are few studies on the treatment of ischemia/reperfusion injury. It is significant to investigate the effect of TanshinoneⅡA on improving uterine ischemia/reperfusion injury in a rat model. OBJECTIVE:To observe the effect of TanshinoneⅡA intervention on improving uterine ischemia/reperfusion injury in rats. METHODS:The rat models of uterine ischemia/reperfusion injury were established by suture method. The rats that were intraperitonealy injected with Sodium Tanshinone IIA Silate injection (20 mg/kg) at 5, 3, 1 days and 30 minutes before the operation were included in the experimental group. Model and sham operation groups were established for comparison. RESULTS AND CONCLUSION:Spectrophotometry and immunohistochemical staining results showed that at 1 and 3 hours of ischemia/reperfusion, the malondialdehyde concentration and Bax protein expression in the injuried rat uterine tissue were significantly decreased (P < 0.05), superoxide dismutase (SOD) activity and Bcl-2 protein expression were significantly increased (P < 0.05) in the experimental group than in the model group. The results confirm that TanshinoneⅡA has a protective effect on uterine ischemia/reperfusion injury in rats.

Objective To evaluate the effects of dexmedetomidine on the hemodynamics and the heart rate variability(HRV)in patients under-going lower limbs operations with application of tourniquet. Methods Forty patients undergoing lower limbs operations with application of tourni-quet were randomized assigned to dexmedetomidine group(group D,n=20)or control group(group C,n=20). After combined spinal-epidural anesthesia,group D received a continuous infusion of dexmedetomidine(0.5μg/kg for 10 min for loading dose and followed by 0.2μg·kg-1·h-1) until tourniquet deflation. The control group received normal saline instead. Mean arterial pressure(MAP),heart rate(HR),saturation of pulse ox-imetry(SpO2),low frequency power(LF),high frequency power(HF)and LF to HF ratio(LF/HF)were recorded at regular time points:imme-diately before loading dose(T0),before tourniquet inflation(T1),15 min after tourniquet inflation(T2),30 min after tourniquet inflation(T3),45 min after tourniquet inflation(T4),60 min after tourniquet inflation(T5),1 min after tourniquet deflation(T6),5 min after tourniquet deflation (T7)and 10 min after tourniquet deflation(T8). Results Compared with T0,the MAP of group D significantly decreased at T6-T8(P<0.05). Compared with T0 and T1,the MAP of group C increased at T2-T5(P>0.05). Compared with T2-T5,the MAP of group C significantly decreased at T6(P<0.05). Compared with group C,the MAP of group D significantly decreased at T6 and T7(P<0.05). Compared with T0,the HR of group D significantly decreased at T1-T8(P<0.05). Compared with T0,the HR of group C had no significant change at T1-T5(P<0.05). Compared with T1-T5,the HR of group D and group C significantly increased at T6(P<0.05). Compared with group C,the HR of group D significantly decreased at T1-T4 and T6(P<0.05). Compared with T0,the SpO2 of group D and group C significantly decreased at T6(P<0.05). Compared with group C,the SpO2 of group D significantly decreased at T1-T3(P<0.05). Compared with T6,LF of group D and group C significantly increased at T7(P<0.05). LF were comparable between groups D and C(P>0.05). Compared with T0,the HF of group D significantly increased and the LF/HF of group D significantly decreased at T1-T4(P<0.05). Compared with group C,the HF of group D significantly increased and the LF/HF of group D significantly decreased at T1-T4(P<0.05). Conclusion The appropriate dose of dexmedetomidine(loading dose 0.5μg/kg and maintenance dose 0.2μg · kg-1 · h-1)can significantly increase vagal tone and improve cardiac sympathetic and parasympathetic balance during tourniquet appli-cation.

Objective To assess the effect of opiod pretreatment on etomidate induced myoclonus. Methods The pertinent literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,and CHKD. Then the meta?analysis was performed by using RevMan 5.2 and STATA 12.0 software. Results A total of 24 RCTs involving 2 396 pa?tients were included for the study. Pretreatment ofμorκ?receptor agonists reduced myoclonus with RR=0.19(95%CI 0.14 to 0.27)and RR=0.22 (95%CI 0.12 to 0.40),respectively. Conclusion Pretreatment of opiods can reduce the incidence of etomidate induced myoclonus.

Objective To improve the understanding of primary pulmonary artery sarcoma(PAS)and its early diagnosis and treatment.Methods The clinical data of 3 PAS patients in Beijing Anzhen Hospital and related literature,the clinical features,diagnosis and therapy of the disease were retrospectively studied.Results Pulmonary artery sarcoma had similar clinical presentations to pulmonary thromboembolism(PTE).Although CT pulmonary angiography and Color Doppler echocardiography etc were helpful to the diagnosis of the entity,the confirmed diagnosis needed the operation.The surgery was main therapy for the disease.Conclusion Pulmonary artery sarcoma is easily misdiagnosed as PTE.The clinicians should pay more attention to the disease so as to early diagnose and treat it.

OBJECTIVE:To provide the basis for the formulation of the health intervention strategy for medical and health insti-tutions'pharmacists and provide reference for other related research. METHODS:A total of 180 medical and health institutions' pharmacists in Heilongjiang province were investigated and evaluated by work satisfaction MMSS scale(modified)and quality of life(SF-36)scale,and the relevant data were analyzed statistically. RESULTS:A total of 180 questionnaires were distributed and 134 valid questionnaires were collected. The effective recovery rate was 74.44%. The average score of work satisfaction degree was (3.44±0.79),which was at the middle level. The highest score was the relationship with colleagues and the lowest score was wel-fare. The physical function,the physiological function and the social function dimension of the respondents were higher thanChi-nese norm. The scores of physical pain,general health,vitality,emotional function and mental health were lower thanChinese norm,and there was statistical significance between the scores of the other dimensions andChinese norm(P<0.05),except for the physiological function and vitality dimension. Multivariate analysis showed that gender,duties,education,length of service and work satisfaction score had an effect on quality of life(P<0.05),among these factors,work satisfaction score was positively correlated with quality of life. CONCLUSIONS:The quality of life of medical and health institutions'pharmacists still needs to be improved,which is related to many influential factors,and job satisfaction is an important influential factor.

Background and purpose:The BRAF V600E mutation is a highly attractive drug target. Therefore, determining the BRAF gene mutation status of patients is essential in order to assess patients' eligibility for targeted BRAF geneinhibitor therapy. The aim of this study was to validate the utility of immunohistochemistry to rapidly obtain the BRAF gene mutation status. This study aimed to analyze the correlation of the BRAF V600E gene mutation and VE1 protein ex-pression with the clinical pathological characteristics in papillary thyroid carcinoma (PTC).Methods:The mutation status of BRAF V600E was detected by DNA sequencing. Immunohistochemistry was used to detect the expression of BRAF V600E protein in 108 cases of PTC, 54 cases of thyroid adenoma and 54 cases of normal thyroid tissue.Results:The gene mutation rate of BRAF V600E is 67.6%, and VE1 protein expression rate is 64.8% in 108 cases of PTC. The differences were statistically significant compared with thyroid adenoma and goiter (P<0.05), but have no correlation with the clinical pathological characteristics.Conclusion:BRAF V600E gene mutation and VE1 protein expression are useful biomarkers for the pathological diagnosis of PTC. High consistency was observed between the immunohistochemical staining results and the DNA sequencingresults of BRAF V600E gene mutations. Immunohistochemical technique detecting the BRAF V600E protein expression can effectively reflect indirectly BRAF V600E gene mutation status in PTC.BRAF V600E gene mutation has no contribution to the development of papillary thyroid carcinoma.

Objective To investigate the changes in prevalence of nutritional risk and undemutrition in patients with head and neck cancer during radiotherapy.Methods In this longitudinal observational study,a convenience sampling method was used to recruit patients with head and neck cancer who were receiving radiotherapy in Beijing Cancer Hospital.Nutritional Risk Screening 2002 (NRS 2002) was applied to assess the prevalence of nutritional risk in the patients,and Patient-Generated Subjective Global Assessment (PG-SGA) and body composition test to determine the prevalence of malnutrition (undernutrition) before,during and after radiotherapy.Results 56 patients finished the three follow-up exams.Along with the progress of radiotherapy,the scores of NRS 2002 increased gradually (1.64±1.09 vs.2.30 ±1.06 vs.3.14 ±1.07,x2 =46.639,P＜0.001),and the prevalence of nutritional risk also increased gradually (21.43％ vs.37.50％ vs.71.43％,x2 =29.700,P ＜0.001);the total scores of PG-SGA [1 (1-13) vs.6 (1-15) vs.12 (1-18),x2 =63.206,P＜0.001] and dimensions of weight [0 (0-4) vs.1 (0-4) vs.3 (0-6),x2 =40.798,P＜0.001],intake [0 (0-2) vs.1 (0-2) vs.2 (0-4),x2=64.707,P＜0.001] and symptoms [0 (0-7) vs.2 (0-10) vs.6 (0-11),x2 =61.562,P ＜ 0.001] all increased gradually with statistical significance.The prevalence of malnutrition in different stage of radiotherapy were significantly different (x2 =64.999,P ＜ 0.001).The body composition analysis in 40 patients showed that all the indicators of body composition decreased significantly along with the progress of radiotherapy.There was a great loss in patients' body weight during radiotherapy,especially the fat-free mass.Conclusions The prevalence of nutritional risk and undernutrition may increase in patients with head and neck cancer during radiotherapy.Lean body mass accounted for most of the weight loss.We should pay more attention to those patients' nutritional status during radiotherapy.

OBJECTIVE:To explore the role of clinical pharmacists in the treatment of pan-drug resistant Acinetobacter bau-mannii infection. METHODS:Clinical pharmacists participated in the treatment for a severe pneumonia case of pan-drug resistant A. baumannii infection. Clinical pharmacists supplied overall pharmaceutical care and suggestions with respects to initial medication scheme evaluation,pathogen judgment,therapy drug selection,ADR disposal,etc.,including anti-infective treatment of moxifloxa-cin 0.4 g,ivgtt,qd+meropenem 0.5 g,ivgtt,q8 h+linezolid 0.6 g,ivgtt,q12 h;anti-pan-drug resistant A. baumannii infection of cefoperazone sodium and sulbactam sodium 3.0 g,ivgtt,q8 h+tigecycline 50 mg,ivgtt,q12 h;liver protection of ademetionine 1, 4-Butanedisulfonate 1.0 g,ivgtt,qd+reduced glutathione 1.8 g,ivgtt,qd. RESULTS:After 25 d treatment,the patient hadn’t been fe-vered,and hemogram and hepatic function index decreased to normal value. CONCLUSIONS:Clinical pharmacist should be en-gage in anti-infective treatment and pharmaceutical care,and provide physicians reasonable medication suggestion so as to promote care rate in the clinic.

Objective:To establish an HPLC method for the determination of gabapentin and the related substances in gabapentin capsules. Methods:A Kromasil C8 column (250 mm × 4. 6 mm,5μm)was used. The mobile phase was methanol-0. 01 mol·L-1 po-tassium dihydrogen phosphate solution (adjusting pH to 6. 9 with 2 mol·L-1 potassium hydroxide) (40∶60). The detection wave-length was 210 nm. The column temperature was 40℃ and the injection volume was 20μl. The main component and the known impuri-ty were determined by an external standard method. The unknown impurities were determined by a self-control method. Results: The calibration curve of gabapentin was linear within the range of 2.5-20.0 mg·ml-1(r=0.999 9). The average sample recovery was 100. 74% with RSD of 0. 24%(n=5). Conclusion:The method is simple, accurate,specific and applicable in the determination of gabapentin and the related substances in gabapentin capsules.